This invention relates to a method of on-site emergency medical treatment for injured or unconscious patients. Using this invention, such treatment can be carried out by anyone trained to administer an intravenous injection (such as police, firemen, military personnel, lifeguards at swimming pools, nursing home attendants, etc.), without waiting for an ambulance to arrive, and without waiting for a medical diagnosis by a physician.
Under the prior art, no effective emergency medical treatment can be performed on injured or unconscious patients who still have a heartbeat (such as victims of accidents or violent crimes, or people who have suddenly lost consciousness without an obvious reason). Instead of effective medical treatment, people at the scene can only offer palliative care, such as laying a patient down and elevating his legs and feet above his head. Such palliative "first aid" does not rise to the level of genuinely effective medical treatment, as offered by this invention.
The difficulties and risks of treating shock victims (i.e., people who suffer a major loss of blood pressure after an injury) illustrate why it previously has been impossible to develop effective pre-diagnostic medical treatments for such victims. There are three different types of shock, and each type has its own set of causes, its own subtly different symptoms, and its own internal mechanisms that increase the severity of internal damage to the victim. These three different types of shock have been labelled:
1. hypovolemic shock, which normally occurs due to loss of blood from the vascular system; PA1 2. cardiogenic shock, in which a heart attack, fibrillation, cardiac arrest, or other such crisis prevents the heart from beating properly; PA1 3. hyperdynamic shock, in which the heart begins pumping too much blood, rather than too little. This can be caused by, for example, a septic infection in which bacteria release endotoxins that attack blood vessel walls.
These three different types of shock are described in more detail in Mouchawar et al, "A Pathophysiological Approach to the Patient in Shock," Int. Anesthesiol. Clin. 31:1-20 (1993). This is a review article which summarizes the various symptoms and uncertainties that doctors must deal with, when trying to figure out how to treat a patient who is in shock.
The crucial point of this analysis is this: proper drug treatment for one type of shock is very different from proper drug treatment for the other types of shock. As one example, vasodilating drugs (which dilate blood vessels) are widely used to treat cardiogenic shock (such as in heart attack victims), because they help reduce the stress on a struggling heart. However, the same vasodilator drugs that are very useful in that type of shock could be potentially deadly, if injected into someone suffering from either of the other two types of shock.
As a second example, inotropic drugs (which increase the pumping strength of the heart; dobutamine is an example) are often used for treating cardiogenic shock; however, it would be potentially lethal if used to treat hypovolemic or hyperdynamic shock.
It is essential to recognize that because of the differences between the three different types of shock, a previously known drug treatments which can help a patient suffering from one type of shock might harm or even kill a patient suffering from a different type of shock. Accordingly, since shock arises so often whenever a life-threatening injury occurs, it usually is deemed safest to do nothing except stand by and wait, until an ambulance arrives to carry the patient away.
The inability of bystanders (and even people trained in responding to emergencies, such as police, firemen, nursing home attendants, etc.) to provide any genuinely useful medical treatment is a tragic gap in modern medicine. Because of various cellular and physiological processes, the extent of damage to internal organs (especially the heart, brain, and kidneys) accelerates and grows rapidly worse, as the minutes pass by after a life-threatening injury or collapse. Rapid on-site emergency medical treatment of such victims, if available during the critical minutes immediately after a severe injury or collapse, could offer extraordinarily useful and humanitarian benefits in preventing death, and in minimizing permanent and potentially crippling damage to the heart, brain, and other organs.
Doctors and researchers have known this for many years, and yet, prior to this invention, there have been no significant breakthroughs of any sort, in terms of developing ways to provide on-site emergency drug treatments for critically injured accident or crime victims, or for people who suddenly collapse and lose consciousness for no apparent reason. As noted above, the only things that are actually done today, for critically injured or ill patients who still have a heartbeat, are limited to minor forms of palliative care, such as lying them down, keeping them warm, and elevating their legs above their heads.
Accordingly, one object of this invention is to disclose a method of emergency drug treatment, using fructose-1,6-diphosphate (FDP) in a form that can be injected into an injured or unconscious person immediately, at the scene of a life-threatening injury or collapse, by anyone who can administer an intravenous injection, without waiting for a doctor or ambulance to arrive.
Another object of this invention is to disclose an effective and beneficial drug treatment, using injectable FDP in a sterile and stable form that can be stored for long periods of time without requiring refrigeration, which can be injected safely into any severely ill, unconscious, or injured patient who needs immediate help, without jeopardizing the patient's status or recovery due to unknown or unforeseen medical factors, and without delaying treatment while waiting for a medical diagnosis.
A third object of this invention is to disclose that chemically stable and sterile partially-lyophilized (freeze-dried) FDP preparations inside sealed vials can be packaged in injection kits, which can be stored for months without refrigeration, in hard-shell kits that can be stored safely in locations such as police cars and firetrucks. If a medical crisis arises, the lyophilized FDP can be mixed with sterile water or saline solution (also contained in the kit, along with an injection syringe) to form an injectable liquid, which can be intravenously injected or infused immediately into the crisis victim. Such injection kits allow rapid and genuinely useful medical intervention, without requiring a medical diagnosis of the patient, and without waiting for an ambulance or doctor to reach the site of a crisis.
These and other objects of the invention will become more apparent through the following summary, drawings, and description of the preferred embodiments.